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Artificial Pancreas Shows Promise In Diabetes Test
An anonymous reader writes A cure for Type 1 diabetes is still far from sight, but new research suggests an artificial "bionic pancreas" holds promise for making it much more easily manageable. From the article: "Currently about one-third of people with Type 1 diabetes rely on insulin pumps to regulate blood sugar. They eliminate the need for injections and can be programmed to mimic the natural release of insulin by dispensing small doses regularly. But these pumps do not automatically adjust to the patient's variable insulin needs, and they do not dispense glucagon. The new device, described in a report in The New England Journal of Medicine, dispenses both hormones, and it does so with little intervention from the patient."
Yep. I'm a *big* fan of my insulin pump, but the included "Constant Glucose Monitoring" device that the pump's company touts as "FDA-approved artificial pancreas!!one11eleven!!" is anything but. It's measuring interstitial fluid, which is *randomly* accurate in *random* people at *random* times. It can neither be trusted, nor should be. And I've since stopped using the CGM side of the pump.
The tech that they're talking about in this article is the same idea: measure interstitial fluid and make insulin decisions based on that. Bad. Ju. Ju.
We need some way of measuring blood glucose levels from, ya know, actual *blood*, without the risk of causing infections. Until we get that, no bueno. Just pass on it.
Jason Van Patten
Why are we screwing around with artificial organs when we can have the real deal?
He. Joking aside, I know someone who actually did get a pancreas transplant, and his Type-1 was *essentially* cured. However. He eats massive handfuls of anti-rej drugs with every meal, all to keep that pancreas functioning. IMHO, not a good trade. At all.
Jason Van Patten
To be successful, this kind of a device will need substantial improvements in Continuous Glucose Monitoring (CGM) devices. I used one of these 2 to 3 years ago, and it required a finger-stick reading to "calibrate" it at a minimum once every 12 hours, but recommended 4 times a day. Even with this calibration, the algorithm in their software didn't adjust to this as truth data, and would continue to read quite different values. Many times this was in the 60-80 point (mg/dL) range. When you're trying to control blood glucose into a range of 80-120 mg/dL, having an error so great is a significant challenge. Granted, this was likely 1 generation old technology, but from what my endocrinologist (who's also a pump wearing diabetic) tells me, the newest generation isn't much better.
I can't imagine what the device would do when you factor this error in along with the algorithm trying to account for situations such as eating, without having additional input from the user.
Oh, and one last hurdle: A newly placed sensor for the CGM devices generally take a period of 1 to 2 hours to acclimate, then need a "calibration", before the data is useful. What does a diabetic do during this time period (which needs to occur once every 3 days)?
Over the past four decades, we've seen squat in the form of treatment for diabetes other than improving the delivery of insulin delivery for diabetics, which has been around since the 1920s. Honestly, it almost seems as if the insulin market is just too lucrative to allow a real cure for Type 1 diabetes. We march on continuing to watch little children struggle with this disease through adulthood and often succumb to an early death because of it. C'mon scientific community. Get your collective heads our of your arses and curse this.
Ditto. I'm a type 1 who has used a pump for the past 7 years. I tried the CGM device for a few months about two years ago, and was really disappointed. The readings were widely inaccurate (sometimes over 100 mg/dl). I also didn't see much point in it if I still had to manually check my blood sugar levels at least 4 times a day to calibrate it. Having an additional piece of equipment stuck in your body all day was also another turn-off.
But the biggest downside? The $35 that each sensor cost out-of-pocket after my insurance fees. When these need to be changed every 3-6 days, that adds up pretty quickly.
I believe that these devices will eventually reach the point of convenience where you'll seldom need to think about type 1 diabetes (outside of filling the pump and changing sensors), but the price is a huge barrier to entry.
If you post as Anonymous Coward, don't expect a reply.
Funny, I was about to write the same thing. My wife has a pump + a continuous monitor, and her experience is just like yours.
It's an interesting idea, but the implementation isn't quite there yet.
]but when done right the results really are quite useful.
All I ask is that you don't judge the entirety of an approach based on your experience with one flawed implementation.
Show me it "done right" with years(!) of lab evidence, trials including hundreds (if not thousands) of individuals, and perhaps I'll believe you. Oh, and when you provide said data, don't be an "Anonymous Coward" about it, either.
No, blood tests aren't 100% accurate. They are, however, a far, *FAR* more accurate way to get an idea of levels than using interstitial fluid. And, as it turns out in this case: accuracy counts. A lot.
Jason Van Patten